title: Prevalence and diversity of Clostridium difficile strains in infants.
abstract: During early infancy asymptomatic intestinal colonization by Clostridium difficile is frequent. To update information on infant colonization prevalence and to characterize infant strains, in terms of their virulence factors and their phylogenetic diversity, a prospective screening of C. difficile in the stools of infants 0 to 2 years old was conducted at Jean Verdier Hospital (Hôpital Jean Verdier) over an 18 month period. C. difficile was screened by toxigenic culture, and molecular characterization was performed by PCR-ribotyping and multilocus sequence typing (MLST). The overall C. difficile colonization prevalence was 33.7 % (99/294). The colonization rate by a toxigenic strain was 7.1 % (21/294). Community-acquired C. difficile accounted for 66.7 % (66/99) of cases. Molecular typing was performed on 90 isolates from Jean Verdier Hospital and 8 additional isolates from another hospital in Versailles (Centre Hospitalier de Versailles). Among these isolates, 23 were toxigenic (21 tcdA(+)/tcdB(+) and 2 tcdA(-)/tcdB(+)). All the isolates were negative for the binary toxin genes. Seventeen PCR ribotypes (PRs) were identified, with five PRs accounting for 82.7 % (81/98) of the isolates. MLST generated 15 different sequence types (STs). The predominant genotype, PRJV11-ST38 (33.7 %), included only non-toxigenic strains. Toxigenic strains were distributed in eight genotypes. Neither PR027-ST3, nor PR078/126-ST49 were identified but some PRs/STs corresponded to well-known adult infectious strains. These results indicate that infants are widely colonized by non-toxigenic strains. However, toxigenic adult infectious strains circulate in asymptomatic infants even in the community; thus, infants may be a reservoir for adult infectious strains.
authors.affiliation: Service de Microbiologie, Hôpital Jean Verdier, Assistance Publique - Hôpitaux de Paris, Bondy, France.|EA 4043, USC INRA, Ecosystème Microbien Digestif et Santé, Université Paris Sud 11, Châtenay-Malabry, France.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Rousseau
authors.affiliation: Service de Microbiologie, Centre Hospitalier Universitaire de Rouen, Rouen, France.|EA 2656, GRAM, Université Médecine-Pharmacie, Rouen, France.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Lemée
authors.affiliation: Service de Microbiologie, Centre Hospitalier de Versailles, Le Chesnay, France.|EA 4043, USC INRA, Ecosystème Microbien Digestif et Santé, Université Paris Sud 11, Châtenay-Malabry, France.
authors.forename: Alban
authors.initials: A
authors.lastname: Le Monnier
authors.affiliation: Service de Microbiologie, Hôpital Jean Verdier, Assistance Publique - Hôpitaux de Paris, Bondy, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Poilane
authors.affiliation: Service de Microbiologie, Centre Hospitalier Universitaire de Rouen, Rouen, France.|EA 2656, GRAM, Université Médecine-Pharmacie, Rouen, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pons
authors.affiliation: Service de Microbiologie, Hôpital Jean Verdier, Assistance Publique - Hôpitaux de Paris, Bondy, France.|EA 4043, USC INRA, Ecosystème Microbien Digestif et Santé, Université Paris Sud 11, Châtenay-Malabry, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Collignon
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000235:genetics*; D003015:Clostridium Infections / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D005602:France / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence
chemical_list: D000900:Anti-Bacterial Agents